Primary Tumours of the Thalamus

McKissock, Wylie; Paine, Kenneth W. E.

doi:10.1093/brain/81.1.41

Cited by 86 publications

(31 citation statements)

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“…The frequency of pediatric thalamic glial tumors encountered during the 12-year study period (5.2%) is similar to that reported by others [4][5][6]. In our experience, pediatric thalamic gliomas most commonly occur in late childhood and adolescence.…”

Section: Discussionsupporting

confidence: 90%

“…Prognostic factors, aside from histologic grade, are difficult to define because most series lack either adequate neuroimaging assessment by current stan-Reardon/Gajjar/Sanford/Heideman/ Walter/Thompson/Merchant/Li/Jenkins/ Langston/Boyett/Kun dards, or routine, uniform histologic confirmation [2][3][4][5][6][7][8][9]. In addition, the evolution of neurosurgical techniques, the variable use of radiation and chemotherapy, and limited single-institution experiences have made it difficult to identify prognostic factors from prior reports [1][2][3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…In the general population, thalamic glial tumors account for 5% of all central nervous system neoplasms [4][5][6]. These tumors have a bimodal age distribution, with incidence highest among children and adolescents (less than 20 years old) and in those older than 40 years [1,5,6,[10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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Bithalamic Involvement Predicts Poor Outcome among Children with Thalamic Glial Tumors

et al. 1998

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Clinical features and treatment of 36 consecutive pediatric patients with thalamic glial tumors confirmed by histology and characterized by neuroimaging were reviewed to identify prognostic factors. The median age at diagnosis was 10 years (range 1–18 years). Twenty-four patients had low-grade tumors (juvenile pilocytic astrocytoma n = 9, fibrillary astrocytoma n = 6, astrocytomas not otherwise specified n = 6, ganglioglioma n = 2 and oligodendroglioma n = 1) and 12 patients had high-grade tumors (glioblastoma multiforme n = 7, anaplastic astrocytoma n = 4 and unclassified malignant tumor n = 1). With a median follow-up of 4.3 years among survivors, estimates of 4-year progression-free survival (PFS) and overall survival (OS) for the entire group are 28 ± 10 and 37 ± 10%, respectively. Low-grade tumors were associated with a significantly better 4-year PFS (36 ± 12 vs. 0% for the high-grade group; p = 0.03) and OS (52 ± 12 vs. 0%; p < 0.001). This review identified that bithalamic involvement, characterized by neuroimaging, exerted an independent and significant negative impact on PFS and OS for patients with low-grade tumors. Estimates of 4-year PFS and OS among patients with low-grade bithalamic versus monothalamic tumors were 58 ± 15 vs. 0% and 85 ± 11 vs. 0% (p < 0.00001), respectively. The presence of bithalamic involvement did not affect outcome among patients with high-grade tumors. Additionally, age at diagnosis, enhancement with neuroimaging contrast, extension beyond the thalamus and extent of surgical resection did not correlate with overall outcome. Because treatment approaches varied during the study period, the impact of radiation therapy or chemotherapy could not be assessed. This contemporary, single-institution series of pediatric thalamic glial tumors demonstrates, for the first time, the statistical significance of bithalamic involvement as a marker of poor prognosis among patients with low-grade glial lesions.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Bithalamic Involvement Predicts Poor Outcome among Children with Thalamic Glial Tumors

et al. 1998

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“…3,7,9,13) Primary thalamic gliomas include a distinct type known as bilateral thalamic glioma, which occurs as a large tumor located in symmetrical areas in the bilateral thalami, and typically manifesting as behavioral impairments varying from personality changes to frank dementia. This type of thalamic tumor can be distinguished clinically and radiologically from other gliomas.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Thalamic Glioma. Case Report.

Uchino

Kitajima

Miyazaki

et al. 2002

Neurol. Med. Chir.(Tokyo)

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A 35-year-old woman presented with a bilateral thalamic glioma manifesting as dysesthesia over the left side of the body and mental deterioration. T 1 -weighted magnetic resonance imaging revealed enlarged bilateral thalami with homogeneous isointensity and no enhancement after gadolinium administration. Histological examination of a stereotactic biopsy specimen identified anaplastic astrocytoma. Radiotherapy and chemotherapy failed to arrest tumor growth. She subsequently died. Magnetic resonance imaging and clinical findings support the view that bilateral thalamic gliomas represent a distinct clinicopathologic entity among thalamic tumors.

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“…4,8,28) These tumors have a bimodal age distribution, with the incidence being highest among children and adolescents, and in adults over 40 years old. 4,8,18,24,25,28,37,38,40) Unfortunately, little is known of the precise nature of these lesions due to a lack of histological verification in many published series. However, stereotactic biopsies of 44 cases showed that the majority of young patients harbored low-grade malignancy glial neoplasms (68.7%), whereas a large number of adult patients presented with high-grade malignancy glial tumors or metastases (78.6%).…”

Section: Introductionmentioning

confidence: 99%

Gross Total Removal of Gliomas in the Pulvinar and Correlative Microsurgical Anatomy.

Ishii

Suzuki

Watanabe

et al. 2002

Neurol. Med. Chir.(Tokyo)

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Tumors in the pulvinar tend to present as circumscribed lesions with exophytic growth into the lateral and third ventricles. These lesions may be best explored via a parietal-transcortical-transventricular approach. If the tumor extends posteriorly or inferiorly, a posterior-interhemispheric-transtentorial approach may provide a good angle of access. Gross total removal of the tumors in the pulvinar of two patients was achieved by surgical sectioning of the unilateral crus of the fornix or the splenium via a transventricular or interhemispheric approach with acceptable risk. These patients are now doing well as students about 6 years following the first operations. During tumor removal, a posterior-interhemispheric-transtentorial approach combined with above-mentioned approaches was useful for orientation of the critical structures in the posterior incisural space. Knowledge of the anatomical relationships of the pulvinar to the crus of the fornix and the choroid plexus, and to the critical structures located in the posterior incisural space is extremely important for neurosurgeons.

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Primary Tumours of the Thalamus

Cited by 86 publications

References 0 publications

Bithalamic Involvement Predicts Poor Outcome among Children with Thalamic Glial Tumors

Bithalamic Involvement Predicts Poor Outcome among Children with Thalamic Glial Tumors

Bilateral Thalamic Glioma. Case Report.

Gross Total Removal of Gliomas in the Pulvinar and Correlative Microsurgical Anatomy.

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